[Pharmwaste] Interestingly large settlement on drug returndiversion

Audet, Adele (DPH) Adele.Audet at state.ma.us
Mon Dec 6 12:09:35 EST 2010


"In certain healthcare setting, nursing homes, hospice, and long-term care facilities, transfer of medicine from one patient to another may be permitted only under the supervision of the attending physicians for both patients.  The pharmacist doesn't get involved with this decision."

This may be the case in TX but not so in MA.  The Director of Pharmacy/Pharmacy in a hospital is responsible for the security of drugs.  In LTCFs, the prescriptions are the property of the residents (the LTCF holds them in a guardian capacity) and cannot be given to another patient.

There are limited situations where medications can be returned to the pharmacy for redispensing but all are in controlled environments e,g, hospitals and LTCFs using unit-dose.  Nothing may be returned from a typical ambulatory patient because the manner of storage and chances for adulteration/tampering are unknowns that the pharmacist cannot determine and therefore not safely dispense.  In addition there are issues for crediting unused medications and informing patients that they are receiving medications that have been already dispensed to and returned by another patient.

Returning unused medications is another opportunity for drug diversion, a crime, and as a threat to public health and safety drug diversion needs to be addressed appropriately.


Adele D. Audet, R. Ph.

Assistant Director, Drug Control Program

MA DPH

305 South Street

Jamaica Plain MA 02130



Phone 617-983-6712

FAX  617-524-8062

________________________________
From: Matthew C. Mireles [mailto:mirelesmc at earthlink.net]
Sent: Monday, December 06, 2010 11:36 AM
To: Howard Anderson; 'Gilliam,Allen'; 'Stevan Gressitt'; 'pharmwaste'
Subject: RE: [Pharmwaste] Interestingly large settlement on drug returndiversion


In Texas and most states, I believe it's illegal accept unused and expired medicines from customers and reuse the medicines.  In certain healthcare setting, nursing homes, hospice, and long-term care facilities, transfer of medicine from one patient to another may be permitted only under the supervision of the attending physicians for both patients.  The pharmacist doesn't get involved with this decision.

Generally, it is considered a possible issue of "standard care" when medicine is accepted from one patient and given to another.  It is illegal to repackage or redistribut medicines beyond their expiry date for any reason.  For safety, most retail pharmacies and clinics will not recycle and reuse donated medicines from a customer.   And we all know about the DEA regs on narcotics and first registrants.

Retails pharmacies based on our survey have been accepting unwanted meds for some time, but this practice is not acknowledged or institutionalized widely.   In TX, some Walgreens would quietly take customers' unused and expired meds (UEMs) and properly dispose of them as "waste".  Recently, a CVS in Houston was discovered to repackage and sale expired meds to customers.

The United Nations WHO strictly prohibits in its Guideline for Donation of Drugs any medicines from individuals for safety reasons.  Donation of drugs can be effective and highly useful in certain circumstances, but WHO only reccomends direct donation from healthcare institutions and drug manufacturers.

Here's another interesting whistleblower story at the pharmacy.  many of you may remember this case in kansas city:  A $2.2 billion verdict was "dispensed" through the civil courts.   A popular pharmacist was caught diluting chemo drugs for thousands of cancer patients.   The whistleblower was an FBI agent who happened to have Pharm.D.

http://www.nytimes.com/2002/10/11/us/2.2-billion-verdict-for-diluting-drugs.html?ref=robert_r_courtney

Others great stories involved pharmacists giving saline solution instead of the flu vaccine.



We study these stories with great interest because they do shed some light on the levels of greed, incompetence and down right criminal activity in our healthcare system.  We study patient safety and healthcare quality, including the pharmaceutical component of the system.







Matthew Mireles


-----Original Message-----
From: Howard Anderson
Sent: Dec 6, 2010 9:48 AM
To: "'Gilliam, Allen'" , 'Stevan Gressitt' , 'pharmwaste' .
bject: RE: [Pharmwaste] Interestingly large settlement on drug returndiversion


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Hi everyone.

Perhaps this whistleblower case caught these people doing something which was not legal in MD and perhaps their controls were not good.

In North Dakota we allow returns to the pharmacy and credit to the patient or payer, when the drugs are in punch cards. The lot number integrity must be maintained, of course.

We also have a very robust prescription drug repository program that gets donations and reuses quite a few drugs when they come back to our participating pharmacies in cards or unit dose, etc.

I hope a case like this does not throw cold water on our programs to keep these drugs out of the disposal system, by reusing them properly.

Check out our we site for information.

Sincerely,

Howard

Howard C. Anderson, Jr.,R.Ph.
Executive Director
North Dakota Board of Pharmacy
1906 E. Broadway Ave.
P.O. Box 1354
Bismarck, ND  58502-1354
Phone (701) 328-9535
Fax (701) 328-9536
Web site www.nodakpharmacy.com
________________________________
From: pharmwaste-bounces at lists.dep.state.fl.us [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Gilliam, Allen
Sent: Monday, December 06, 2010 7:33 AM
To: 'Stevan Gressitt'; pharmwaste
Subject: RE: [Pharmwaste] Interestingly large settlement on drug returndiversion

Good story Stevan!

That's one down with how many more left, conducting the same practice?

allen gilliam
adeq state pretreatment coordinator
501.682.0625
-----Original Message-----
From: pharmwaste-bounces at lists.dep.state.fl.us [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Stevan Gressitt
Sent: Friday, December 03, 2010 5:55 PM
To: pharmwaste
Subject: [Pharmwaste] Interestingly large settlement on drug return diversion
http://www.prweb.com/releases/2010/12/prweb4859734.htm



Stevan Gressitt, M.D.
Faculty Associate, University of Maine Center on Aging
Academic Member, Athens Institute for Education and Research
Athens, Greece
Founding Director, International Institute for Pharmaceutical Safety
University of New England, College of Pharmacy
Department of Pharmaceutical Sciences
Associate Professor of Clinical Psychiatry
University of New England, College of Osteopathic Medicine
716 Stevens Avenue
Portland, Maine 04103
gressitt at gmail.com<mailto:gressitt at gmail.com>
Cell: 207-441-0291
www.benzos.une.edu<http://www.benzos.une.edu/>
www.safemeddisposal.com<http://www.safemeddisposal.com/>

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